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albumin for transfusion (Albuminar)

Tradename: Albuminar [pharmacologic agent]. Indications: - volume expansion/hypovolemia after crystalloid therapy has failed (see SAFE study) - replacement solution for plasma exchange - spontaneous bacterial peritonitis [3] - large volume paracentesis [4] Contraindications: - critically ill adults with thermal injuries (burns), ARDS or septic shock for volume replacement or to increase serum albumin [2,4] - cardiovascular surgery patients for volume replacement or to prime the cardiovascular bypass circuit - patients with cirrhosis & extraperitoneal infections - hospitalized patients with decompensated cirrhosis & low serum albumin - outpatients with cirrhosis & recalcitrant ascites despite diuretic therapy - patients who undergo hemodialysis, for preventing or treating hypotension or for improving ultrafiltration [4] * relative contraindications Dosage: - 500 mL of 5% albumin (25 g) solution IV PRN Packaging: 1) human pooled blood fraction 2) 50, 250, 500, 1000 mL, (contains 145 meq of NaCl) Adverse effects: 1) infrequent (1-10%) - precipitation of congestive heart failure or pulmonary edema due to hypervolemia - hypotension - tachycardia - fever/chills - rash - nausea/vomiting 2) other [2] - bleeding due to decreased coagulation factors & decreasedvplatelet aggregation - allergic reactions - secondary Creutzfelt Jacob disease (CJD) is possible

Related

albumin (ALB)

Specific

25% albumin 5% albumin

General

transfusion component

References

  1. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 613-614
  2. The NNT: Colloid Solutions for Resuscitation in Critically Ill Patients. http://www.thennt.com/nnt/colloids-for-resuscitation-in-critically-ill-patients/ - Perel P, Roberts I Colloids versus crystalloids for fluid resuscitation in critically ill patients. Cochrane Database Syst Rev. 2011 Mar 16;(3):CD000567 PMID: 21412866 - Delaney AP, Dan A, McCaffrey J, Finfer S. The role of albumin as a resuscitation fluid for patients with sepsis: a systematic review and meta-analysis. Crit Care Med. 2011 Feb;39(2):386-91. Review. PMID: 21248514 - Caironi P et al. Albumin replacement in patients with severe sepsis or septic shock. N Engl J Med 2014 Mar 18 PMID: 24635772 http://www.nejm.org/doi/full/10.1056/NEJMoa1305727
  3. Medical Knowledge Self Assessment Program (MKSAP) 17, 18. American College of Physicians, Philadelphia 2015, 2018.
  4. Callum J, Skubas NJ, Bathla A et al. Use of intravenous albumin: A guideline from the International Collaboration for Transfusion Medicine guidelines. Chest 2024 Mar 4; [e-pub]. PMID: 38447639 Free article https://journal.chestnet.org/article/S0012-3692(24)00285-X/fulltext